3 November 2005  Confronting the possibility of a potentially devastating human bird flu pandemic, the United Nations system – from Secretary-General Kofi Annan to the Economic and Social Council (ECOSOC) to the UN health and agricultural agencies – today laid out a blueprint for immediate preventive and mitigating action.

At the same time, a senior UN health expert said no one can predict the risk of a possible mutation of the virus into a pandemic, nor its potential death toll, which some estimates have put in the scores of millions. "The risk is there, it's a true risk, but it can't be quantified," UN World Health Organization (WHO) official David Heymann said in New York.

Declaring that merely stockpiling antiviral medicines does not constitute a strategy, Mr. Annan highlighted seven priorities to combat the threat of the H5N1 virus.

These include: greater investment in veterinary infrastructure to halt the virus among birds; changing the habits of people living in close proximity with animals; identifying what is needed to keep countries running in case of a pandemic; scaling up production of antiviral medicines for all who need them; fostering transparency and cooperation on science and research; communicating vital facts about the virus to avoid the 'silence is death' syndrome; and mobilizing political leadership at the highest level.

"We do not know yet whether the current strain of avian flu will cause a human pandemic. But we do know what a human pandemic is," Mr. Annan told the Time Global Health Summit, a three-day event in New York held to discuss key health issues.

"We do know what happens when millions of people die, and millions more are infected. When health systems are overburdened and overwhelmed. When families, communities and whole societies are devastated. When transport and trade, education and other services are disrupted or cease to function. When the economic and social progress of nations risks being reversed," he said.

"And whatever we may not know about the future course of H5N1, we do know this: once human-to-human transmission has been established, we would have only a matter of weeks to lock down the spread before it spins out of control. That is why the international community must take action now."

At a separate ECOSOC event, the Council President, Ambassador Munir Akram of Pakistan, proposed quickly establishing a fund to help developing countries take preventive action and compensate farmers and producers for the cost of culling poultry.

"The situation calls for collective action – for more support for global public goods like investment and research in vaccines and for actions that would ensure that the entire world shares in the burden and costs of prevention," Mr. Akram said.

Compensation for losses is considered particularly important by experts not only to avoid crippling economic damage, but to reduce the disincentives farmers and others might have to report new flu case.

"The UN system needs to re-task itself" to aid prevention against a pandemic and support the needs of developing countries," the Senior UN System Coordinator for Avian and Human Influenza, David Nabarro told the session.

Speaking for the UN Food and Agricultural Organization (FAO), Assistant Director-General Louise Fresco said the cost of prevention at source among animals would be about $425 million, but only $30 million has been made available so far.

"Now that $425 million, we know from experience, is peanuts usually compared to the costs which you will have when you have to eliminate entire poultry sectors," she told a subsequent news conference.

Ever since the first human case of bird flu, linked to widespread poultry outbreaks in Viet Nam and Thailand, was reported in January last year, health officials have warned that H5N1 could evolve into a global influenza pandemic if it mutates into a form which could transmit easily between people. The so-called Spanish flu pandemic of 1918-1920 is estimated to have killed from 20 million to 40 million people worldwide.

Dr. Heymann, Representative of the UN World Health Organization (WHO) Director-General, asked at the news conference about the potential human toll, said no one could quantify the risk. "There is no estimate of deaths because it's not possible. This virus can become more virulent as it mutates, more strong; it can become less virulent.

"It can pick up human transmissibility or it can't pick up human transmissibility. No one knows, no one can give you that answer. So the risk is there, it's a true risk, but it can't be quantified," he added.

In the present outbreak there have so far been more than 121 reported human cases, 62 of them fatal, all in South-East Asia, but no human-to-human transmission. Some 140 million domestic birds have died or been culled in an effort to curb the spread.